Provider Demographics
NPI:1427171909
Name:ROONEY, PHYLLIS MONTROSE (LMHP)
Entity type:Individual
Prefix:MS
First Name:PHYLLIS
Middle Name:MONTROSE
Last Name:ROONEY
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:MS
Other - First Name:PHYLLIS
Other - Middle Name:MONTROSE
Other - Last Name:DARDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHP
Mailing Address - Street 1:92-1982 KULIHI ST
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-3414
Mailing Address - Country:US
Mailing Address - Phone:808-295-5319
Mailing Address - Fax:
Practice Address - Street 1:92-1982 KULIHI ST
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-3414
Practice Address - Country:US
Practice Address - Phone:808-295-5319
Practice Address - Fax:888-375-8883
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2825101YM0800X
HIMHC-621101YM0800X
HI44486101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health